title: Age and adverse drug reactions from psychopharmacological treatment: data from the AMSP drug surveillance programme in Switzerland.
abstract: OBJECTIVE
  The frequency of severe adverse drug reactions (ADRs) from psychotropic drugs was investigated in hospitalised psychiatric patients in relation to their age. Specifically, the incidence of ADRs in patients up to 60 years was compared to that of patients older than 60 years.
  
  
  METHODS
  Prescription rates of psychotropic drugs and reports of severe ADRs were collected in psychiatric hospitals in Switzerland between 2001 and 2010. The data stem from the drug surveillance programme AMSP.
  
  
  RESULTS
  A total of 699 patients exhibited severe ADRs: 517 out of 28,282 patients up to 60 years (1.8%); 182 out of 11,446 elderly patients (1.6%, ns). Logistic regression analyses showed a significantly negative relationship between the incidence of ADRs and patients' age in general and in particular for weight gain, extrapyramidal motor system (EPMS) symptoms, increased liver enzymes and galactorrhoea. A significantly negative relationship was observed for age and the dosages of olanzapine, quetiapine, risperidone, valproic acid and lamotrigine. When comparing age groups, frequency of ADRs was lower in general for antipsychotic drugs and anticonvulsants, in particular for valproic acid in the elderly. Weight gain was found to be lower in the elderly for antipsychotic drugs, in particular for olanzapine. For the group of mood-stabilising anticonvulsants (carbamazepine, lamotrigine and valproic acid) the elderly exhibited a lower incidence of reported allergic skin reactions.
  
  
  CONCLUSIONS
  The results suggest that for psychiatric inpatients the incidence of common severe ADRs (e.g., weight gain or EPMS symptoms) arising from psychotropic medication decreases with the age of patients.
authors.affiliation: Department of Psychiatry, Ludwig Maximilian University of Munich, Munich, Germany. waldemar.greil@gmx.ch
authors.forename: Waldemar
authors.initials: W
authors.lastname: Greil
authors.forename: Anne
authors.initials: A
authors.lastname: Häberle
authors.forename: Thomas
authors.initials: T
authors.lastname: Schuhmann
authors.forename: Renate
authors.initials: R
authors.lastname: Grohmann
authors.forename: Pierre
authors.initials: P
authors.lastname: Baumann
mesh_terms: D000293:Adolescent; D000328:Adult; D016907:Adverse Drug Reaction Reporting Systems; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018692:Antimanic Agents / Q000009:adverse effects*; D014150:Antipsychotic Agents / Q000009:adverse effects*; D001480:Basal Ganglia Diseases / Q000139:chemically induced / Q000453:epidemiology; D001569:Benzodiazepines / Q000009:adverse effects; D002220:Carbamazepine / Q000009:adverse effects; D015984:Causality; D003987:Dibenzothiazepines / Q000009:adverse effects; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D005260:Female; D005687:Galactorrhea / Q000139:chemically induced / Q000453:epidemiology; D006801:Humans; D000077213:Lamotrigine; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009459:Neuroleptic Malignant Syndrome / Q000453:epidemiology; D000077152:Olanzapine; D000069348:Quetiapine Fumarate; D018967:Risperidone / Q000009:adverse effects; D012720:Severity of Illness Index; D013557:Switzerland / Q000453:epidemiology; D014227:Triazines / Q000009:adverse effects; D014635:Valproic Acid / Q000009:adverse effects; D015430:Weight Gain; D055815:Young Adult
chemical_list: D018692:Antimanic Agents; D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D014227:Triazines; D001569:Benzodiazepines; D000069348:Quetiapine Fumarate; D002220:Carbamazepine; D014635:Valproic Acid; D018967:Risperidone; D000077152:Olanzapine; D000077213:Lamotrigine